DHBs discuss the all-too-human impediments to telemedicine

Sathya Mithra Ashok |
Dec. 17, 2013

Dr John Garrett, liaison paediatrician for Canterbury and West Coast DHBs talks about the continuing investment in video conferencing technology, even as he draws a picture of underutilisation that needs to be overcome.

"Clinicians have got to recognise that some of the patients travel a long way, they have got to recognise that sometimes when they see the patients, they don't even need to examine them, and that they can do that by video conference. So it is getting them to change their thinking about it," says Garrett.

There is work to be done to get patients to accept the conferencing element as well, but generally this is not too hard, since they are the ones who have to travel and take the time off from work.

"To increase adoption DHBs should also make sure that all the background services are in place. The reality is that at the moment they probably are not. Booking a video conference appointment is still a lot more complicated than doing it face-to-face. Mostly because you have got to book two locations for the one appointment and those two locations might be in different DHBs.

"It gets a bit more complex if the patient goes to the local GP to be seen by a hospital doctor. But we are working on a few of those things now to try and make it all work well.

"If I had to guess there might be 10,000 patients who could be seen every year in Canterbury by video conference. Right now we are seeing closer to a 1000 than 10000. So we have got potentially a lot more we could do," says Garrett.

The two DHBs are working to empower all the clinical staff who are already sold on the video conferencing idea by giving them access to equipment and making processes easy for when they want to work on the technology.

To get those who are not convinced yet, they are working on a couple of other angles.

"The South Island DHBs are trying to develop one new, better and combined patient administration system. A system that tracks patients on waiting lists, books them into clinics and co-ordinates everything for them. At the moment, there are five DHBs with potentially five different systems, and it gets really difficult to look after people who might be in two different DHBs.

That's quite a big project, but that one that is fundamental, says Garrett.

The DHBs are also working to map patients — place their location on a map — so clinicians can see where they have to travel from for each appointment as part of their medical history. This, they hope, will make clinicians re-think the necessity of each appointment, and maybe move some to become video conferences.

"The National Health IT Board is trying to do a bit of work to look at how funding might work for telemedicine consultations — to try to incentivise it. That does not exactly involve paying you more for doing it, but trying to work around how individual DHBs charge other DHBs if they see their patients.